Sport bei Schwangerschaft

Die Fragen ob, wieviel und wie intensiv oder welche Art von Sport während der Schwangerschaft möglich ist, führen häufig noch zu Verunsicherung. Lange Zeit galt die Annahme, dass Sport für Schwangere und das Ungeborene schädlich sein könnte. Der vorliegende Artikel soll über die Benefits und potenziellen Risiken von Sport während der Schwangerschaft aufklären und praktische Empfehlungen zu der Gestaltung eines Trainingsprogramms zusammenfassen.

Kernaussagen

• Die Evidenzlage weist deutlich darauf hin, dass ein angepasstes körperliches Training bei einem normalen Schwangerschaftsverlauf bedenkenlos durchgeführt werden kann und nicht mit einem erhöhten Risiko für Komplikationen einhergeht.

• Vor Beginn bzw. Weiterführung eines Sportprogramms während der Schwangerschaft müssen allgemeine und spezifische gynäkologische Kontraindikationen abgeklärt werden.

• Ein Sportprogramm sollte an die schwangerschaftstypischen anatomischen und physiologischen Veränderungen des Körpers angepasst werden.

• Regelmäßige körperliche Aktivität und Sport sind mit zahlreichen Benefits für die Schwangere und das Neugeborene assoziiert.

• Idealerweise sollte während der Schwangerschaft eine Kombination aus einem Ausdauer- und Krafttraining durchgeführt werden.

Schlüsselwörter

Schwangerschaft - körperliche Aktivität - Ausdauertraining - Krafttraining - Lebensstil - körperliche Fitness - Sport

Publication History

Article published online:
12 August 2024

• Literatur

• 1 American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 10. Philadelphia, PA: Lippincott Williams & Wilkins, Wolters Kluwer; 2018
• 2 Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ 2006; 174: 801-809 DOI: 10.1503/cmaj.051351. (PMID: 16534088)
• 3 Cilar Budler L, Budler M. Physical activity during pregnancy: a systematic review for the assessment of current evidence with future recommendations. BMC Sports Sci Med Rehabil 2022; 14: 133 DOI: 10.1186/s13102-022-00524-z. (PMID: 35842718)
• 4 Wang SM, Dezinno P, Maranets I. et al. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol 2004; 104: 65-70 DOI: 10.1097/01.AOG.0000129403.54061.0e.
• 5 Mei Q, Gu Y, Fernandez J. Alterations of pregnant gait during pregnancy and post-partum. Sci Rep 2018; 8: 2217 DOI: 10.1038/s41598-018-20648-y. (PMID: 29396468)
• 6 Vladutiu CJ, Evenson KR, Marshall SW. Physical activity and injuries during pregnancy. J Phys Act Health 2010; 7: 761-769 DOI: 10.1123/jpah.7.6.761. (PMID: 21088307)
• 7 Rankin J. Physiology in Childbearing. With Anatomy and related Biosciences. 5. Amsterdam: Elsevier; 2024
• 8 Artal R, Masaki DI, Khodiguian N. et al. Exercise prescription in pregnancy: weight-bearing versus non-weight-bearing exercise. Am J Obstet Gynecol 1989; 161: 1464-1469 DOI: 10.1016/0002-9378(89)90905-8. (PMID: 2603900)
• 9 Gajera D, Trivedi V, Thaker P. et al. Detailed review on gestational diabetes mellitus with emphasis on pathophysiology, epidemiology, related risk factors, and its subsequent conversion to type 2 diabetes mellitus. Horm Metab Res 2023; 55: 295-303 DOI: 10.1055/a-2061-9441. (PMID: 36963428)
• 10 Benham JL, Gingras V, McLennan NM. et al. Precision gestational diabetes treatment: a systematic review and meta-analyses. Commun Med (Lond) 2023; 3: 135 DOI: 10.1038/s43856-023-00371-0. (PMID: 37794196)
• 11 Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation 2014; 130: 1003-1008 DOI: 10.1161/CIRCULATIONAHA.114.009029. (PMID: 25223771)
• 12 Corso M, Miarka B, Figueiredo T. et al. Effects of aerobic, strength, and combined training during pregnancy in the blood pressure: a systematic review and meta-analysis. Front Physiol 2022; 13: 916724 DOI: 10.3389/fphys.2022.916724. (PMID: 36111150)
• 13 Kominiarek MA, Peaceman AM. Gestational weight gain. Am J Obstet Gynecol 2017; 217: 642-651 DOI: 10.1016/j.ajog.2017.05.040. (PMID: 28549978)
• 14 Koletzko B, Cremer M, Flothkötter M. et al. Diet and lifestyle before and during pregnancy – practical recommendations of the Germany-wide Healthy Start – Young Family Network. Geburtsh Frauenheilkd 2018; 78: 1262-1282
• 15 Institute of Medicine. Weight Gain during Pregnancy: reexamining the Guidelines. Washington, DC: National Academies Press (US); 2009
• 16 Ruchat SM, Mottola MF, Skow RJ. et al. Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 1347-1356 DOI: 10.1136/bjsports-2018-099399. (PMID: 30337461)
• 17 da Silva SG, Ricardo LI, Evenson KR. et al. Leisure-time physical activity in pregnancy and maternal-child health: a systematic review and meta-analysis of randomized controlled trials and cohort studies. Sports Med 2017; 47: 295-317 DOI: 10.1007/s40279-016-0565-2. (PMID: 27282925)
• 18 Chan CW, Au Yeung E, Law BMH. Effectiveness of physical activity interventions on pregnancy-related outcomes among pregnant women: a systematic review. Int J Environ Res Public Health 2019; 16: 1840 DOI: 10.3390/ijerph16101840. (PMID: 31126153)
• 19 Nascimento SL, Surita FG, Cecatti JG. Physical exercise during pregnancy: a systematic review. Curr Opin Obstet Gynecol 2012; 24: 387-394 DOI: 10.1097/GCO.0b013e328359f131. (PMID: 23014142)
• 20 Schoenfeld B. Resistance training during pregnancy: safe and effective program design. Strength Cond J 2011; 33: 67-75 DOI: 10.1519/SSC.0b013e31822ec2d8.
• 21 Lardon E, St-Laurent A, Babineau V. et al. Lumbopelvic pain, anxiety, physical activity and mode of conception: a prospective cohort study of pregnant women. BMJ Open 2018; 8: e022508 DOI: 10.1136/bmjopen-2018-022508. (PMID: 30389759)
• 22 Davenport MH, Ruchat SM, Poitras VJ. et al. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 1367-1375 DOI: 10.1136/bjsports-2018-099355. (PMID: 30337463)
• 23 Di Mascio D, Magro-Malosso ER, Saccone G. et al. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol 2016; 215: 561-571 DOI: 10.1016/j.ajog.2016.06.014. (PMID: 27319364)
• 24 Russo LM, Nobles C, Ertel KA. et al. Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Obstet Gynecol 2015; 125: 576-582 DOI: 10.1097/AOG.0000000000000691. (PMID: 25730218)
• 25 Martin CL, Brunner Huber LR. Physical activity and hypertensive complications during pregnancy: findings from 2004 to 2006 North Carolina Pregnancy Risk Assessment Monitoring System. Birth 2010; 37: 202-210 DOI: 10.1111/j.1523-536X.2010.00407.x. (PMID: 20887536)
• 26 Wesnes SL, Seim E. Birthweight and urinary incontinence after childbirth: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X 2020; 8: 100115 DOI: 10.1016/j.eurox.2020.100115. (PMID: 32954252)
• 27 Davenport MH, Nagpal TS, Mottola MF. et al. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 1397-1404 DOI: 10.1136/bjsports-2018-099780. (PMID: 30337466)
• 28 Kardel KR, Johansen B, Voldner N. et al. Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women. Acta Obstet Gynecol Scand 2009; 88: 948-952 DOI: 10.1080/00016340903093583. (PMID: 19562561)
• 29 Becker M, Weinberger T, Chandy A. et al. Depression during pregnancy and postpartum. Curr Psychiatry Rep 2016; 18: 32 DOI: 10.1007/s11920-016-0664-7. (PMID: 26879925)
• 30 Sun W, Chen D, Wang J. et al. Physical activity and body image dissatisfaction among pregnant women: A systematic review and meta-analysis of cohort studies. Eur J Obstet Gynecol Reprod Biol 2018; 229: 38-44 DOI: 10.1016/j.ejogrb.2018.07.021. (PMID: 30099226)
• 31 Jackson MR, Gott P, Lye SJ. et al. The effects of maternal aerobic exercise on human placental development: placental volumetric composition and surface areas. Placenta 1995; 16: 179-191 DOI: 10.1016/0143-4004(95)90007-1. (PMID: 7792281)
• 32 de Oliveria Melo AS, Silva JL, Tavares JS. et al. Effect of a physical exercise program during pregnancy on uteroplacental and fetal blood flow and fetal growth: a randomized controlled trial. Obstet Gynecol 2012; 120: 302-310 DOI: 10.1097/AOG.0b013e31825de592. (PMID: 22825089)
• 33 Juhl M, Olsen J, Andersen PK. et al. Physical exercise during pregnancy and fetal growth measures: a study within the Danish National Birth Cohort. Am J Obstet Gynecol 2010; 202: 63.e1-63.e8 DOI: 10.1016/j.ajog.2009.07.033. (PMID: 19800601)
• 34 Clapp JF, Kim H, Burciu B. et al. Beginning regular exercise in early pregnancy: effect on feto-placental growth. Am J Obstet Gynecol 2000; 183: 1484-1488 DOI: 10.1067/mob.[phone]. (PMID: 11120515)
• 35 Davenport MH, Meah VL, Ruchat SM. et al. Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 1386-1396 DOI: 10.1136/bjsports-2018-099836. (PMID: 30337465)
• 36 Clapp JF. The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol 2003; 110: S80-S85 DOI: 10.1016/s0301-2115(03)00176-3. (PMID: 12965094)
• 37 Mottola MF, Davenport MH, Ruchat SM. et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med 2018; 52: 1339-1346 DOI: 10.1136/bjsports-2018-100056. (PMID: 30337460)
• 38 Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol [Anonym]. 2020; 135: e178-e188 DOI: 10.1097/AOG.0000000000003772. (PMID: 32217980)
• 39 Bø K, Artal R, Barakat R. et al. Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women. Br J Sports Med 2018; 52: 1080-1085 DOI: 10.1136/bjsports-2018-099351. (PMID: 29895607)
• 40 Leung Y, Gibson G, White S. et al. Exercise during pregnancy. Australian and New Zealand College of Obstetricians and Gyecologists. 2020 Accessed May 27, 2024 at: https://ranzcog.edu.au/wp-content/uploads/2022/05/Exercise-during-pregnancy.pdf
• 41 Walani SR. Global burden of preterm birth. Int J Gynaecol Obstet 2020; 150: 31-33 DOI: 10.1002/ijgo.13195. (PMID: 32524596)
• 42 Beetham KS, Giles C, Noetel M. et al. The effects of vigorous intensity exercise in the third trimester of pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2019; 19: 281 DOI: 10.1186/s12884-019-2441-1. (PMID: 31391016)
• 43 Quenby S, Gallos ID, Dhillon-Smith RK. et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet 2021; 397: 1658-1667 DOI: 10.1016/S0140-6736(21)00682-6. (PMID: 33915094)
• 44 Davenport MH, Kathol AJ, Mottola MF. et al. Prenatal exercise is not associated with fetal mortality: a systematic review and meta-analysis. Br J Sports Med 2019; 53: 108-115 DOI: 10.1136/bjsports-2018-099773. (PMID: 30337346)
• 45 Newton ER, May L. Adaptation of maternal-fetal physiology to exercise in pregnancy: the basis of guidelines for physical activity in pregnancy. Clin Med Insights Women’s Health 2017; 10: 1179562×17693224 DOI: 10.1177/1179562X17693224. (PMID: 28579865)
• 46 Wiebe HW, Boulé NG, Chari R. et al. The effect of supervised prenatal exercise on fetal growth: a meta-analysis. Obstet Gynecol 2015; 125: 1185-1194 DOI: 10.1097/AOG.0000000000000801. (PMID: 25932847)
• 47 McMurray RG, Mottola MF, Wolfe LA. et al. Recent advances in understanding maternal and fetal responses to exercise. Med Sci Sports Exerc 1993; 25: 1305-1321 (PMID: 8107536)
• 48 Davenport MH, Yoo C, Mottola MF. et al. Effects of prenatal exercise on incidence of congenital anomalies and hyperthermia: a systematic review and meta-analysis. Br J Sports Med 2019; 53: 116-123 DOI: 10.1136/bjsports-2018-099653. (PMID: 30337347)
• 49 Ravanelli N, Casasola W, English T. et al. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Br J Sports Med 2019; 53: 799-805 DOI: 10.1136/bjsports-2017-097914. (PMID: 29496695)
• 50 Bjarnason-Wehrens B, Schulz O, Halle M. et al. Leitlinie körperliche Aktivität zur Sekundärprävention und Therapie kardiovaskulärer Erkrankungen. Clin Res Cardiol 2009; 4: 1-44 DOI: 10.1007/s11789-009-0078-8.
• 51 Evenson KR, Hesketh KR. Monitoring physical activity intensity during pregnancy. Am J Lifestyle Med 2021; 17: 18-31 DOI: 10.1177/15598276211052277. (PMID: 36636387)
• 52 Szumilewicz A, Santos-Rocha R, Worska A. et al. How to HIIT while pregnant? The protocol characteristics and effects of high intensity interval training implemented during pregnancy – a systematic review. Balt J Health Phys Act 2022; 14: 1-16 DOI: 10.29359/BJHPA.14.1.01.